Practice Quiz

MACE Medication Aide

Category - MACE

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You are seeing an elderly patient with congestive heart failure. Both nesiritide and bosentan have been recommended for this patient. Which of the following statements are true, if any?
  1. Nesiritide should not be used in patients with a systolic pressure under 90mm Hg. Bosentan may be used in these patients.
  2. Bosentan is an ACE inhibitor and should be used cautiously in elderlypatients with pulmonary hypertension.
  3. Both A and B are correct.
  4. A is correct, but B is incorrect. The systolic pressure may safely be less than 90mm Hg as long as the patient is continuously monitored.
Explanation
Answer: A - A is a correct statement. Neseritide (Natracor) is a B-type natriuretic peptide vasodilator and is contraindicated in obstructive cardiomyopathy and in hypotensive patients with systolic pressures less than 90 mm Hg. Bosentan (Tracleer) is an endothelin-receptor agonist (not an ACE inhibitor) and should be used cautiously in patients with mitral stenosis or pulmonary hypertension and with elderly patients. LFT are required with bosentan use.
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